Introduction: Penetrating cardiac injuries generally occur secondary to gunshot or stab wounds and have a high mortality rate. They are rare and often fatal in children. When a foreign object penetrates the myocardium, it is dangerous to remove it, suddenly, and should be removed gradually to prevent excessive bleeding. Case report: We report a case of an unusual penetrating cardiac injury in a 12-year-old boy with a rivet pushed into his sternum and penetrating the right ventricle. After the patient underwent sternotomy and pericardiotomy, the site of the rivet was exposed. A purse was then sutured around the rivet and tightened while pulling it out. The patient was discharged five days post-op, with normal echocardiography after 12 months. A review of the English-written literature revealed that this is the first case of heart trauma with rivet.

Introduction Emerging hypotheses suggest a causal role for prenatal androgen exposure in some cases of Autism spectrum disorders (ASD). The ratios of the lengths of the bones of the 2nd to the 4th digits (2D:4D) are purported to be markers for prenatal androgen exposure and to be established early in gestation. Ratio of second and fourth digits (2D:4D) is usually used as a proxy for prenatal testosterone. Methods and Materials In this study, 2D:4D in 48 children with ASD and in 41 control child was measured. Two groups were matched with the gender and age. Both groups were selected by convenience sampling method. All statistical analyses were performed using SPSS 19.0 software, considering as significant less than .05 (p < .05). Results: Results showed that the average ratio of 2D:4D in ASD children were lower than the ratio in control children (P<0.05(. 2D to 4D finger-length ratio of the right of children with autism was lower than the normal children (P<0.05(; while this difference was not significant between the two groups in the left hand (P>0.05(. Conclusion: The results indicate that the 2D:4D ratio could be used together with other parameters as an indicator of the likelihood of developing autistic traits in offspring. Results achieved in this research can be valuable in further biological and psychological approaches in neurocognitive research and diagnostics of children from ASD.

Background: Malnutrition among tribal preschool children is highly prevalent in almost all states of India and is the predisposing factor for morbidity as well as mortality. Objectives: Aim of the study was to detect prevalence of malnutrition and their associated factors. Study design: A cross sectional study. Study subjects: Lodha tribal children aged 1-5 years. Sample size: A total of 141 children were included in the present study. Data collection: Data was collected in pre-structured questionnaire, which included household socio-demographic data, morbidity status of child and anthropometric measurements like height, weight. Results: The overall prevalence of malnutrition in the form of underweight, stunting, wasting and overweight was 40.4%, 29.8%, 34.0%, 5.0%, respectively. According to the WHO classification of severity of malnutrition, the overall prevalence of underweight and wasting was very high, indicating a critical situation. The reported morbidity was 20.6% and majority of children suffered from diarrhoea (7.8%). The results revealed that morbidity status, number of sibling, mother literacy status had significant association on underweight More importantly; rate of underweight was significantly higher among children who had reported morbidity, no of sibs 3 and above and or illiterate mothers. They had 3.7, 2.15 and 2.81 times greater risk of being underweight. Similarly, children having morbidity had more than 3 times greater chance of developing wasting. Conclusion: The Lodha pre-school children were suffering from nutritional stress which was associated with reported morbidity, mother’s lack of education and high number of siblings.

Introduction: drug use in pediatric patients is a unique dilemma in the management and monitoring of disease. This study aimed at assessing medication prescribing in a pediatric ward of an Ethiopian hospital. Materials and Methods: a retrospective cross-sectional study was done by reviewing the medical records of 249 patients among those admitted in the period between 11th of September 2007 and 10th of September 2008 to the pediatric ward of Gondar University Referral Hospital, Northwest Ethiopia. Data on characteristics like age, sex and weight; the diagnoses for which patients were admitted and medications prescribed to them during their stay in the ward was collected from the medical records of the patients. Results: an average of 3 diagnoses per patient with the most frequently diagnosed being malnutrition (29.23%), severe community acquired pneumonia (12.96%) and underweight (8.86%) were reported. A mean of 4.5 medications per patient with the most commonly prescribed being antibacterials namely penicillins which constituted 25.42%, other antibacterials making up 19.61% and medications used for correcting water, electrolyte and acid-base disturbances accounting for 17.19% of the total number of medications prescribed in the ward. The most common individual medications prescribed to the patients included crystalline penicillin, gentamicin and maintenance fluid constituting 9.22, 7.52 and 6.45 percentages respectively most of them in solution forms which were administered dominantly intravenously. Conclusion In this study the common prescription of antibacterials and those used for correcting water, electrolyte and acid-base disturbances was observed which went with the common diagnoses of malnutrition and pneumonia.

Abstract:Introduction: Racial and environmental differences in communities leading cause of differences in serum lipids. It can be said this study aimed in assessing percentile curves of serum lipid profile about 6-18 years old students of Birjand.Method: The present cross-sectional study was done on 4168 students of Birjand aged 6-18 years. They were classified into three age groups 6-10 and 15-18 and 11-14 years. The 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of lipids (cholesterol, LDL, HDL and triglycerides) were determined by sex for different age groups.Result: The 5th, 10th, 25th, 50th, 75th, 90th and 95th percentiles for cholesterol, LDL, HDL, and TG were 114,123, 138, 157, 176, 197, 210; 54, 59, 71, 86, 102, 119, 131; 33, 36, 41, 48, 56, 64, 68 and 43, 49, 61, 78, 103, 138, 164, respectively. Conclusion: Percentiles of lipid in kids of Birjand are different in comparison with reference percentiles of the U.S and also Tehran. Triglycerides and HDL in children and adolescents of Birjand were higher and lower, respectively than the Americans. This could be due to racial differences and environmental factors such as nutrition and sedentary life style. This should be considered in interpretation of normal and abnormal values and determination of dyslipidemia in children and adolescents. Take the regional percentiles of serum lipids for Iranian children and adolescents recommended by examining a sufficient number of samples.

Background and objectives: the weaning procedure of mechanical ventilation in many patients is a difficult and long process and increases the time of mechanical ventilation. There are numerous ways to achieve this goal. One common way is using CPAP-ventilator. Considering the lower price of Blender-Humidifier compared to CPAPof ventilator and the limited number of studies in this field, this study was aimed to compare these two procedures.Methods: 102 patients in pediatric Intensive Care Unit (PICU) were allocated randomly in one group: CPAP-ventilator and Blender-Humidifier. Duration of hospital and PICU stay, the number of days of mechanichal ventilation, the frequency of re-intubation, and the mortality of the patients were recorded. Results: the study was conducted on 66 male and 36 female patients (64.7% and 35.3% respectively). The average age was 22.5 ± 4.5 months. The most frequent complaint of the patients at the time of visit was coughing (35%), hyperventilation and respiratory distress (21.6%). Hospital stay was 23±14 and 20±12days in humidifier and cpap groups respectively (p=0/52).PICU stay was 15± 11and 20±11 days in humidifier and cpap groups respectively (p=0/18).Re- intubation rate was 16/2% and 33/5% in humidifier and cpap groups respectively (p=0/15).Mortality rate 8/4% and 21.5% in humidifier and cpap groups respectively (p=0/06). Conclusion: Although there was no statistically significant difference between two groups, considering the differences in mortality rate, the need for re-intubation, rate of hospital and PICU stay, and at the same time, with easy availability and low prices, using Blender- Humidifier is recommended.

Introduction: Eating Disorder Symptoms and social anxiety can be occurring in the same time. Also social anxiety is one of the important factors predicting Eating Disorder symptoms which vary among different cultures and countries. The aim of this study was to determine the relationship between Eating Disorder symptoms and social anxiety in school boys. Materials and Methods: This was a cross-sectional study on 361 high school boys in isfahan who were selected through two-step random sampling. The students completed a questionnaire concerning demographic characteristics, Eating Disorder Questionnaire and social anxiety. Data were analyzed by the statistical tests of Pearson correlation coefficient, Student’s t-test, one-way analysis of variance (ANOVA), and regression through SPSS version 14. Results: Based on the findings, the mean (SD) value for age was 14.14 (1.2) years and for BMI was 23.25 (0.3).35.2% had eating disorder and 17.5% bulimia and30% had anorexia nervosa Symptoms. Also there was a positive correlation between the rate of Eating Disorder Symptoms, bulimia and anorexia nervosa and social anxiety. (P=0.004, r= 0.287, P=0.001, r= 0.257, P=0.020, r= 0.242). Conclusions: There was correlation between the Eating Disorder Symptoms and social anxiety in school boys.So educating people like caregivers by community health midwives regarding nutritional problems in during adolescence can be effective in early diagnosing and identifying such disorders.

Background: Helicobacter pylori is the cause of serious diseases including gastric cancer and gastric mucosa–associated lymphoid tissue lymphoma.50% of world population is infected by this microorganism and it -based on epidemiologic studies - is mainly acquired during childhood . there is not enough evidence about prevalence of this infection in children and its risk factors so encourage us to study on it.Method : we tested 282 apparently healthy 9-12 year old students in a population based cross sectional study for Helicobacter pylori colonization using H pylori Antigen EIA Test Kit (ACON company).a short socio demographic questionnaire was used to assess risk factors.Findings: the overall prevalence of H pylori colonization in 282 students is 13.1%. we found statistically significant relationship between H pylori colonization and sex, duration of breast feeding, and family crowding but there is not significant relationship with age , family history of dyspepsia , number of days in week consuming yogurt and economically stratified living region in present study.Conclusion: Helicobacter Pylori is a big concern even in young asymptomatic children and it needs to be further studied about its potential risk factors and how to manage them for the goal of prevention.

Background: Chest radiography is one of the most usual diagnostic tools for respiratory distress. Objective: The purpose of this study is to assess the specificity, sensitivity and clinical value of chest radiography of neonates with respiratory distress.Patients and Methods: A descriptive- analytical study was conducted on 102 neonates that were in neonatal intensive care unit of Imam Reza and 22 Bahman Hospitals because of respiratory distress. After confirming the neonate's respiratory distress and taking chest radiography, the radiography was described by a radiologist and final diagnosis was confirmed. Results: Most of the neonates (64.7%) were born with caesarian section and were premature (78.4%). Respiratory distress syndrome (RDS) was the most common reason for respiratory distress (38.2%). Chest radiography had the most sensitivity and specificity in pneumothorax and hernia (100%). For pneumosepsis, radiography had 73% sensitivity and 87% specificity, for RDS the sensitivity and specificity were 35% and 82% respectively, for congenital heart disease sensitivity of zero and specificity of 98% and for Transient tachypnea of neonates (TTN) sensitivity of zero and specificity of 100%. The conformity of clinical and radiography was also calculated as 79.4% in respiratory distress Discussion and Conclusion: Although chest radiography is used as one of the most usual and accessible diagnostic tools in respiratory distress syndrome, but inaccurate specificity and sensitivity in some disease must be considered, especially in neonates.

Introduction Low birth weight (LBW) is a high risk for children's health and a problem of public health in under developing countries. SGA increases neonatal and infant death, and neonatal and adult morbidity. So the present study aimed to assess the incidence of LBW, SGA and their related factors in Sabzevar in 2011 to 2012. Materials and Methods This prospective descriptive-analytic study was conducted on 481 low birth weight neonates born in Mobini academic hospital of Sabzevar in 2011. Neonates who their BW was Results 480 (6.33%) of participating newborns were LBW (out of 7599). Mean weight of LBW neonates was 2039.1±9.6 g. Among LBW neonates, 62 (12.7%) and 24 (5%) of neonates were VLBW and ELBW, respectively. 162 (34.1%) of neonates were SGA (out of LBW neonates). SGA rate was 2.2% (out of total newborns). Family income (p-value=0.026) and mother's education (p-value=0.004) were significantly lower in SGA neonates rather than LBW neonates. The incidence of mothers' urinary infection in VLBW neonates was significantly higher than non-VLBW neonates (p-value<0.001). Conclusion: Findings showed that LBW and SGA incidence were similar to these statistics in developed countries and also other cities of Iran. But most types of growth retardation were asymmetric, in reverse to the reference books.

Introduction Daily rhythm as one of the biological rhythms with a period of about 24 hours on various body systems and physiological responses affect on them. Body temperature is a fundamental variable as one of the specifications used daily rhythms The main purpose of this study was evaluating the effect of circadian rhythms on exercise performing and physiological variants of security system in swimmers. Materials and Methods In one study, before and after the 12 men swimmers in the league, of Fars Province with an average age of 19.80+1.87 years, had been invited, and after explaining the situation and also completed a written consent form purposefully participated in the study. To measure the length of 400m and 50 meters breast stroke timer QQ model CR2032 (China) was used. The one-way analysis of variance (ANOVA) was used to this study. Result Results showed body temperature significantly increased from 6:00 to 18:00. Circadian rhythms significantly showed increase from 6 to 18 (P<0.05); circadian rhythms significantly showed effect on performing record in 400m and 50m chest crawl swimming with decrease of influence in 18:00 rather than 6:00; also circadian rhythms significantly showed influence on Immunoglobulin A (IgA) in resting after 400m and after 50m swimming with increasing from morning to evening (P<0.05(. But in Immunoglobulin G (IgG) not significant increase in 6:00 until 18:00 in three conditions. The effects of activities in IgA in 6:00 showed decrease after 400m swimming and increasing after 50m, and in 18:00 increasing after 400m and 50m, but not significant activity in 6:00 showed significantly increase effects in IgG after 400m and 50m swimming and not significant decrease in 18:00 the received (P>0.05(. Conclusion In this study, the body temperature exercise performance and IgA variant of security system, were influenced by circadian rhythms and kinds of practicing programs in 18:00 change IgG. So in the time of measuring body temperature exercise performance and variants of salivary of security system must be pied attention to influence of cicardian rhythms.

Family is one of the most important grounds of crime and crime victimization development. The experts, welfare workers, lawyers and sociologists argue that the factor or factors should be identified that provide the kind of conditions under which the individuals abuse, tolerate or accept the crime in order to secure the society, reduce the social harms and finally propose the procedures to reform it. The purpose of this study is to investigate the crime victimization of children in the city of Qom. So, a questionnaire was distributed and completed through the interviews with the parents live in this city and who have a child or children. The questionnaires were analyzed by the SPSS software. The sample size was 266 individuals. The findings of research show that there is a meaningful inverse relationship among the children' control by their families, the rate of children belonging to their families, family cohesion and tendency towards criminal behavior. In other words, as the above mentioned variables increase, the children' tendency towards criminal behaviors decrease and vice versa. The analysis of variance (ANOVA) test was used to compare the family structure with the children' tendency towards criminal behaviors. The result of this test shows a significant difference. In other words, the comparison of means suggests that the children with separated parents are more inclined to criminal behaviors.

Introduction There is an agreement that eating disorder is related to psychological characteristics and on the other hand, level of ghrelin hormone, Intercellular adhesion molecule-1 (ICAM-1) and E-selection also change during eating disorders. We aimed to study the relationship between eating disorders and rest levels, ICAM-1, E-selection, and ghrelin hormone in obese people. Materials and Methods In this quasi-experimental study, 120 obese men (25-30 years old) were purposefully selected. Then the data about their eating disorders gathered with eating attitudes test (EAT-26) questionnaire. In the next phase in the rest condition and after overnight fasting, blood samples are collected for measurement of rest levels, ICAM-1, E-selection, and ghrelin hormone. Finally the data were analyzed with appropriate statistical tests in SPSS version 18. Results Mean and deviation of rest levels, ICAM-1, E-selection, and ghrelin hormone were respectively 3064.19, 61.5±19.7, and 2.5±1.5 and there was not any statistical significance relationship between eating disorders ICAM-1, E-selection, and ghrelin hormone in obese men (P<0.05(. Conclusion According to our results, the prevalence of eating disorders can be a reason other than rest Levels, ICAM-1, E-selection, and ghrelin hormone.

Over 800,000 people die due to suicide every year and there are many more who attempt suicide. Hence, many millions of people are affected or experience suicide bereavement every year. Suicide occurs throughout the lifespan and was the second leading cause of death among 15-29 year olds globally in 2012. It is a global phenomenon in all regions of the world; Suicide accounted for 1.4% of all deaths worldwide, making it the 15th leading cause of death in 2012. The Quran makes it clear that human life is sacred. Life cannot be taken without justification and the right to life is inherent in the tenants of Islam. Life itself is a gift from the Creator that we are obliged to care for. Suicide out of despair of God’s mercy or worldly problems is strictly forbidden.